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Kindler′s syndrome is a very rare genodermatosis characterized by acral blistering starting in infancy, photosensitivity, progressive poikiloderma, cutaneous atrophy, and various forms of mucosal involvement. A large number of other cutaneous and extracutaneous features have also been described. We report here three cases of Kindler′s syndrome from eastern India for the rarity of the syndrome and to emphasize the importance of considering this condition in the differential diagnosis of disorders that can cause blistering, cutaneous atrophy, and/or poikilodermatous skin changes.

Background : ′Holi′ is an annual spring festival celebrated all over India. The central ritual of Holi involves throwing of colors on one another. Playing with toxic industrial dyes often results in various dermatological complaints in a significant number of people immediately following the celebration. Aims : To describe patterns of various skin manifestations directly or indirectly related to the use of different colors in the celebration of Holi. Methods : Observational clinical study on consecutive patients presenting to a teaching hospital in Kolkata, India. Results : Forty-two patients with a mean age of 24.2 years were studied. Itching was the commonest symptom (25, 59.5%), followed by burning sensation, pain, oozing, and scaling. Eleven patients′ symptoms were attributed to activities related to preparation of colors and the removal of colors from the skin surface. Eczematous lesions were the most common pattern (24, 57.1%) followed by erosions, xerosis and scaling, erythema, urticaria, acute nail-fold inflammation, and abrasions. Thirteen (30.9%) patients reported aggravation of preexisting dermatoses (acne, eczema, and paronychia). Secondary pyoderma occurred in 3 (7.1%). Face was the commonest site affected (24, 57.1%), followed by dorsum of the hands, scalp, forearm, palms, arms, and trunk. Ocular complaints in the form of redness, watering, and grittiness occurred in 7 (16.7%) patients. Conclusion : Various forms of cutaneous manifestations, often associated with ocular complaints, occur commonly due to Holi colors. Public awareness and regulatory actions are needed to avoid these preventable conditions.

Background: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disease resulting in a wide array of clinical manifestations, primarily affecting the skin and central nervous system. Mucocutaneous features play a very important role in the recognition of this syndrome. Aims: To review the prevalence and patterns of cutaneous manifestations in tuberous sclerosis, in a group of patients from eastern India. Methods: Observational clinical study on twenty-seven consecutive patients of tuberous sclerosis collected during a period of four years. Results: Most were between 10-20 years of age; the male to female ratio was 2:1. Family history was found in two-thirds. The classical triad of tuberous sclerosis was present in only nine (33.3%) patients. Adenoma sebaceum was the most common cutaneous feature (100%), followed by hypomelanotic macules (92.6%), connective tissue nevi (66.6%), and Koenen′s tumors (33.3%). Oral mucosal fibromas were seen in six (22.22%) patients. Fibromatous plaque over forehead and scalp was seen in three patients. Limitation of the study was small size of study sample. Conclusion: Prominent mucocutaneous changes are extremely common manifestation of TSC, which may provide crucial diagnostic clues for primary care physicians.

A family consisting of a brother (11 years) and his twin sisters (13 years) with cerebrotendinous xanthomatosis is presented. The brother had bilateral achilles tendon xanthoma, low intelligence, poor memory with early cerebellar signs. The sisters had bilateral juvenile cataracts in addition to Achilles tendon xanthomas. The serum cholosterol level in all the three was within normal limits. The FNAC and histopathology of tendinous swelling showed touton giant cells and foam cells. A diagnosis of cerebro- tendinous xanthomatosis was made on the basis of Achilles tendon xanthomas, bilateral cataracts and normal serum cholesterol.

A close ended questionnaire study on knowledge attitude and practice (KAP) about HIV/AIDS was conducted amongst first year MBBS students immediately on joining the course. One hundred and fourteen students participated in the study. Overall level of knowledge about AIDS was found to be 72%. Boys were better informed about possible methods of prevention of AIDS than girls. Misconceptions regarding mode of transmission, clinical presentation and prevention existed amongst large number of them. Seventeen percent of boys and 5% of girls approved of pre-marital sex for boys while 14.8% of boys approved the same for girls. Thirteen and half percent of boys admitted sexual experience. Awareness programme should be intensified amongst students to improve the overall knowledge of AIDS.

Primary tuberculosis of the glans penis is extremely rare. We report a case in a 47 years old man who presented with an ulcer over glans, which mimicked malignancy. The diagnosis of tuberculosis was confirmed by biopsy and response to antituberculous chemotherapy. There was no co- exiting tuberculous infection elsewhere. The wife of the patient was under treatment for pulmonary tuberculosis. The possibility of acquiring the disease following sexual contact could not be ruled out. The importance of biopsy in the diagnosis of chronic genital ulcer is emphasized.

We report a case of granuloma faciale over distal extremities in a 60-year-old man without facial lesions who did not show any response to dapsone.

A patient of Graves†disease with unusually large asymmetrical lobulated swelling over both the skin is reported. The pathogenesis of localised myxoedema and its predilection for lower extremities is discussed.

A patient with nodular swelling over scalp in presented. The histopathology of the lesion is consistent with angiolymphoid hyperplasia with eosinophilia. The subtle differences form Kimuraâ€s diseases are discussed.

A patient with tuberculous ulceration of the vulva is reported. Tuberculosis of the external genitalia is unusual and primary infections are rare. Venereal transmission of the infection could not be proved in the patient. Healing of the ulcer followed antitubercular chemotherapy. The importance of biopsy in the diagnosis of chronic genital ulcer is emphasized.

Complications due to rifampicin administration have been well documented, especially for the treatment of tuberculosis. Multidrug therapy for the leprosy patients advocates rifampicin of monthly interval and at the level of intermittent administration, complications are rarely noted. An adult male of tuberculoid leprosy developed acute renal failure at the time of second and third monthly doses of rifampicin therapy.

Psoriasis vulgaris is a chronic, autoimmune skin disease involving a complex interplay of epidermal keratinocytes, dermal fibroblast and infiltrating immune cells. Differential expressions of miRNAs are observed in psoriasis and the deregulated miRNAs are sometimes associated with disease severity. This study aims to identify miRNAs altered in the serum of psoriasis patients that are associated with the Psoriasis Area and Severity Index (PASI). In order to assess miRNA levels in the serum of psoriasis patients, we selected 24 differentially expressed miRNAs in the psoriatic skin are possibly derived from the skin and immune cells, as well as five miRNAs that are enriched in other tissues. We identified 16 miRNAs that exhibited significantly (p < 0.05) altered levels in the serum of psoriasis patients compared to healthy individuals. Among these, 13 miRNAs showed similar expression pattern in the serum of psoriasis patients as also observed in the psoriatic skin tissues. Ten miRNAs showed an accuracy of greater than 75% in classifying the psoriasis patients from healthy individuals. Further analysis of differential miRNA levels between the low PASI group and the high PASI group identified three miRNAs (miR‐147b, miR‐3614‐5p, and miR‐125a‐5p) with significantly altered levels between the low severity and the high severity psoriasis patients. Our systematic investigation of skin and immune cell‐derived miRNAs in the serum of psoriasis patients revealed alteration in miRNA levels to be associated with disease severity, which may help in monitoring the disease progression and therapeutic response. [ABSTRACT FROM AUTHOR]

Byline: Falguni. Nag, Gobinda. Chatterjee, Arghyaprasun. Ghosh, Abhishek. De Background: A chronic leg ulcer (CLU) is a significant public health problem. It has various etiologies. Racial, familial, occupational, and social [...]

Byline: Nirmalya. Das, Abhishek. De, Biswanath. Naskar, Amrita. Sil, Sudip. Das, Aarti. Sarda, Gobinda. Chatterjee Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae affecting the skin, peripheral [...]

Byline: Projna. Biswas, Dayamay. Pal, Abhishek. De, Gobinda. Chatterjee, Arghyaprasun. Ghosh, Sudip. Das, Pijush. Das, Aarti. Sarda, Sumit. SenIntroduction: Primary cutaneous amyloidosis (PCA) can be classified into four principal categories: [...]

Background: Rheumatoid arthritis (RA) has both articular and extra-articular manifestations, with certain dermatoses occurring in increased frequencies in this population. Since clinicodemographic profile varies according to ethnicity and geographic location, the present study was conducted to record the dermatological presentations of RA in Eastern Indian population. Materials and Methods: This was an observational cross-sectional study conducted in a tertiary care hospital in Eastern India on adult patients of either sex attending the department of Dermatology. Consecutive patients were recruited and detailed clinicodemographic profile was recorded in a pretested, semi-structured pro forma. Results: Three hundred and twenty-four consecutive patients with a female predominance (M: F = 1:3.3) who fulfilled the eligibility criteria were recruited. Thirty-six patients had more than one cutaneous manifestation. Three hundred and sixty-two dermatological manifestations were noted with 57 (15.7%) having specific findings, 14 therapy-related adverse effects and 291 (80.4%) nonspecific findings. Vascular changes were commonest (22; 6.1%) followed by rheumatoid nodules (3.3%) and leg ulceration (2.8%). Rheumatoid factor was found positive in 233 (71.9%) cases and anti-citrullinated peptide antibody (ACPA) was positive in 250 (77.2%) cases. There was statistically no significant association between specific dermatological manifestations and age, duration, and family history of RA, rheumatoid factor, and ACPA positivity. Conclusion: Awareness and recognition of various skin manifestations is essential for a concerted therapeutic approach to patients with RA. [ABSTRACT FROM AUTHOR]

Byline: Abhishek. De, Abu. Hasanoor Reja, Ishad. Aggarwal, Sumit. Sen, Amrita. Sil, Basudev. Bhattacharya, Nidhi. Sharma, Asad. Ansari, Aarti. Sarda, Gobinda. Chatterjee, Sudip. Das Background: Pure neural leprosy (PNL) still [...]

Byline: Arghyaprasun. Ghosh, Rahul. Ahar, Gobinda. Chatterjee, Neha. Sharma, Shruti. Jadhav Background: Congenital ichthyoses comprises various specific genetic diseases and can range from mild to very severe presentation. Furthermore, these [...]

Background: Alopecia areata is an autoimmune disorder affecting the hair-bearing sites of the body. Trichoscopy has recently been practiced in the diagnosis of alopecia areata. Aim: To elicit trichoscopy patterns in alopecia areata and to find out any correlation of trichoscopic findings with disease severity. Methods: Trichoscopy was done on clinically diagnosed cases of alopecia areata and on age and sex-matched controls without hair disorders by using a DL1 dermoscope (magnification: ×10). Observed dermoscopic findings were analyzed to find the correlation with disease severity. Results: In total, 87 cases and 60 controls were included in the study with the mean age for cases being 25.47 ± 14.07 years. There was male predominance of cases (51; 58.62%). Alopecia in multiple patches was the most common type (42; 48.27%), and scalp was the most common site of involvement (79; 90.8%). Yellow dots (YD), black dots (BD), broken hairs (BH), circle hair (CH), and tapering hairs (TH) or exclamation hair (EH) were found to be statistically significant findings in alopecia areata as compared to controls. Circle hair was significantly associated with total severity of alopecia areata (P = 0.041). Yellow dots had a positive correlation with the number of episodes of alopecia areata (Spearman's rho = 0.273, P = 0.0106) and mean severity of alopecia tool (SALT) score (P = 0.0130). No significant association was noted between trichoscopic findings and disease activity, family history, disease associations, or nail involvement. Conclusion: A constellation of trichoscopic findings helps in establishing the diagnosis of alopecia areata obviating the need for biopsy. [ABSTRACT FROM AUTHOR]

Wolf isotopic response is the occurrence of new dermatoses on areas of the skin with previous but still active dermatoses. Vitiligo is an acquired disorder characterized by the loss of functional melanocytes which manifests as circumscribed depigmented macules and patches. Dermatophytoses are superficial fungal infections caused by three genera of fungi (Microsporum, Trichophyton, and Epidermophyton) that have the unique ability to invade and multiply within keratinized tissue (skin, hair, and nail). The appearance of dermatophyte infection on previously present vitiligo lesion is an uncommon example of Wolf response. We describe a case series of five vitiligo patients that presented to our OPD over 1 year period. [ABSTRACT FROM AUTHOR]

Background: Systemic sclerosis (SSc) is an autoimmune connective tissue disorder causing microvascular abnormality leading to Raynaud's phenomenon, skin tightening, and nailfold capillary changes. The patient may have systemic involvement, among them interstitial lung disease (ILD) and pulmonary arterial hypertension are mainly associated with disease-related mortality. Aims: To find out an association between nailfold capillaroscopic changes with ILD severity. Materials and Methods: An institution based cross-sectional study was performed among the patients of SSc above 18 years. Detailed history was taken. Clinical examinations, nailfold capillaroscopy (NFC) with a dermatoscope and high-resolution computed tomography (HRCT) scan of thorax were done. Data were analyzed in MedCalc statistical software version 20. Results: Out of total 43 patients, 74.4% (n = 32) were female. Mean age was 35.05 ± 7.24 years and mean duration 4.28 ± 2.81 years. Diffuse SSc was found in 88.37% (n = 38). On NFC, early, active, and late patterns were found in 30.2% (n = 13), 25.6% (n = 11), and 44.2% (n = 19) cases, respectively. On HRCT, early, active, and late ILD were present in 18.6% (n = 8), 37.2% (n = 16), and 30.2% (n = 13) cases, respectively. ILD changes were absent in 14% (n = 6) though NFC changes were present in them. Respiratory symptoms were absent in 20.93% (n = 9) patients though all had features of early NFC and among them 9.3% (n = 4) showed early ILD changes on HRCT. Significant associations were found between NFC changes and ILD severity (P = 0.0003), NFC changes and respiratory symptoms (P < 0.0001) and between ILD changes and respiratory symptoms (P < 0.0001). Discussion: NFC, an inexpensive procedure, can be performed in all patients of SSc to detect development of early ILD even before appearance of respiratory symptoms to prevent further progression. [ABSTRACT FROM AUTHOR]